Organization Active NPI

Mindsmattersmd LLC

  • Neurology Physician
  • Springfield, MO
National Provider Identifier
1356962799
Registry record updated Dec 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
MINDSMATTERSMD LLC
Practice address
1736 E Sunshine St Ste 603
Springfield, MO 65804-1333
Phone
(844) 476-6600
Fax
(417) 356-8078
NPI assigned
Apr 27, 2020
Last updated
Dec 31, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Osamede Edokpolo, MDNPI 1326334459
Title
Owner/Medical Director
Phone
(313) 506-3036

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

1736 E Sunshine St Ste 603
Springfield, MO 65804-1333

Mailing address

1736 E Sunshine St Ste 603
Springfield, MO 65804-1333
Phone (844) 476-6600

Other identifiers 1

IdentifierTypeStateIssuer
1326334459MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210504002898 MO Part B Supplier - Clinic/Group Practice 3971912932 Receives reassigned benefits from 2 practitioners
Practice locations: Springfield, MO

National Provider Directory

National Provider Directory

Locations

3305 Clark Ln
Columbia, MO 65202

3322 S Campbell Ave
Ste T10
Springfield, MO 65807
Phone (844) 476-6600

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1587945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767139200000",
    "number": "1356962799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1736 E SUNSHINE ST STE 603",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658041333",
            "telephone_number": "844-476-6600",
            "fax_number": "417-356-8078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1736 E SUNSHINE ST STE 603",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658041333",
            "telephone_number": "844-476-6600",
            "fax_number": "417-356-8078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDSMATTERSMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-27",
        "last_updated": "2025-12-31",
        "certification_date": "2025-12-31",
        "status": "A",
        "authorized_official_last_name": "EDOKPOLO",
        "authorized_official_first_name": "OSAMEDE",
        "authorized_official_title_or_position": "OWNER/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "313-506-3036",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326334459",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.